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HomeMy WebLinkAboutSPRING FOREST BLK 2 LT 12 MUNICIPALITY OF ANCHORAGE On -Site Water & Wastewater Program PO Box 196650 4700 Elmore Road Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997 hftp://www.muni.org/onsite On -Site Wastewater Disposal System Permit Permit Number: OSP231377 Work Type: SepticTank Upgrade Tax Code Number: 01534221000 Site Legal Address: SPRING FOREST BLK 2 LT 12 G:2538 Site Mailing Address: 6121 WEST TREE DR, Anchorage Owner: NICKEL ROGER A & KAREN K Design Engineer: FIRST WATER CONSULTING This permit is for the construction of: Effective Date Expiration Date Lot Size in Sq Ft Total Bedrooms: p�cnt 11 I t�ep�u•tment 12/12/2023 12/11/2024 55312 ❑ Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction shall be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80) 3. The wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing j Special Provisions: 1. The engineer is to confirm that the 1983 system was decommissioned. Please note on the IR/RD. 2. The 1989 field was not approved. The new survey is to show all the field standpipes to confirm that the required separations are being met. F�eceived-By: Issued By: Date: Date: 4 OF nMCH0F%_,\ GE_ Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section --� Fax: 907-343-7997 ON-SITE SEPTIC/WELL PERMIT APPLICATION Parcel I.D. 015-342-21 Property owner(s) ROGER & KAREN NICKEL TRUST... Day phone _ Mailing address 6121 WEST TREE DRIVE, ANCHORAGE, AK 99507 Site address 6121 WEST TREE DRIVE, ANCHORAGE, AK 99507 Legal .description (Sub'd., Block & Lot) SPRING FOREST BLOCK 2, LOT 12 Legal description (Township, Range & Section) Lot Size 55,312 Sq. Ft. Number of Bedrooms 4 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field ❑ Initial ❑ Single Family (SF) 0 Septic Tank 0 Upgrade (w/wo ADU) Holding Tank ❑ Renewal ElDuplex (D) El Privy ❑ Multiple Dwellings ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit/Rush Fees: 2 Z Waiver Fees: Date of Payment: i I 2 4 Z07-13 Date of Payment: Receipt Number: _ f Z �� Z Receipt Number: Permit No. ©S (� 2 3 3 Waiver No. GADevelopment Services\Building Safety\On Site Water and Wastewater\Forms\Client Forms\Permit Application.doc 13030 Sues Way, Anchorage, AK 99516 907-350-9566 / firstwaterAK@gmail.com ! !! December 8, 2023 Municipalities of Anchorage On-Site Water & Wastewater Program 4700 Elmore Road Anchorage, AK 99507 RE: SEPTIC TANK UPGRADE PERMIT LEGAL: SPRING FOREST BLOCK 2, LOT 12 The owner has requested that we obtain a septic permit to upgrade the existing aged steel septic tank on the above referenced lot. We propose to install a 1500-gallon epoxy coated steel or IM- 1530 Infiltrator septic tank per the attached design to serve the existing 4-bedroom residence. No groundwater was noted in the 1989 or 1983 test holes, however there may be groundwater on site and if groundwater is encountered during installation an anchored epoxy coated 1500-gallon steel or IM-1530 septic tank may be required. Per the owner, the previous existing tank was decommissioned and filled in with concrete with abandonment of the original absorption field. The lot and area are served by public water and the waterline will be staked prior to construction along with any encroaching property lines, easements, … that must be staked prior to construction. The design will not impact any of the neighboring properties. Please contact us if you have any questions. Sincerely, Curtis Huffman, P.E. Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP231377, Deb Wockenfuss, 12/12/23 FIRST WATER CONSULTING SPRING FOREST BLOCK 2, LOT 12 DESIGN DETAILS: Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP231377, Deb Wockenfuss, 12/12/23 MUNICIPALITY OF ANCHORAGE •o •e •ve•l •o •p •m •e •n •t •s•e •rv•ic•e•s •o•e•p•a•rt•m•e•n•t---• Ii}\ --------•P•h•o•n •e •: •9 •07•_•3•4 •3-_7 •9•0•4On-Site Water & Wastewater Section � Fax: 9 07-343-7 997 Septic System Owner-installer Agreement The On-site Water and Wastewater Section (On-site) may issue an approval for a homeowner to perform work on an on-site wastewater disposal system to serve that individual's owner­occupied, single-family or duplex home if the homeowner meets and agrees to the following requirements: 1.The prope rty owner and excavation equipment operator may perform work on no morethan one owner-installation project in a 12-month period. 2. 3.The. name of the excavation equipment operator: 4.I agree that there will be no monetary compensation for installation services rendered. 5.The name of the inspecting engineer: FIRST WATER CONSULTING 6.I agree to discuss the following items with the inspecting engineer:a. Permit design criteria and specifications.b.Inspection requirements set forth in AMC 15.65.070.c.Advance notice given to the On-site Water & Wastewater Section for all requiredmunicipal inspections (AMC 15.65.070A). 7.I agree to have the project-specific On-site Wastewater Disposal System Permit availableat the construction site for the duration of all related work. 8.I agree that if the system is an advanced wastewater treatment system (AWWTS), I willobtain additional installation instructions and approval from the equipment distributor. As owner of (legal description).Sff/¼ h&BrS«o, 3'-k:.. 2 /.L)7/z_ 1 agree that the information above is true and a curate. Date: /t /z/4 .5 --,7...__-17...__�-- Mailing Address: P. 0. Box 196650 * Anchorage, Alaska 99519-6650 * www.rnuni.org ______________________________Troy Donahoo Owner's projected active involvement with the installation:__________________________________________________________________________________________________________________________________________Excavation and grade check NOTE: 1) GROUND LEVEL IMPROVEMENTS NOT VERIFIED DUE TO SNOW AND ICE COVER. ASPHALT MAY ENCROACH ON LOT 11 2) LOT IS SERVED BY A PUBLIC WATER SUPPLY PLOT PLAN AS BUILT —2L SCALE 1' = 60' GRID SW 253$ Project No. 23-553A1 11500 Daryl Avenue, Anchorage, Alaska 99515-3049 Lang & Associates, inc. (907) 522-6476 Phone kenOlangsurvey.com Professional Land Surveyors jonothanOlongsurvey.com ���` � OF A(qi ryonOlangsurvey.com ��P., , "Ib 1 hereby certify that I have surveyed the following described property: LOT 12, BLOCK 2, SPRING FOREST SUBDIVISION (PLAT No. 83-7) Anchorage Recording District, Alaska, and that the improvements situated thereon are within the property lines and do not encroach onto the property adjacent thereto, that no Improvements on the property lying adjacent thereto encroach on the surveyed premises and that there are no roadways, transmission lines or other visible easements on said property except as Indicated hereon. 4;t Dated this the Day of ""``` t at Anchorage, Alaska It is the responsibility of the owner to determine the existence of any easements, covenants, or restrictions which do not appear on the recorded subdivision plat. 48TH 1 KENNETH G. LANG No 542 ' ��li:�oFFss10R' State of Alaska AECC963 \ U W 3Ld PLOT PLAN AS BUILT —2L SCALE 1' = 60' GRID SW 253$ Project No. 23-553A1 11500 Daryl Avenue, Anchorage, Alaska 99515-3049 Lang & Associates, inc. (907) 522-6476 Phone kenOlangsurvey.com Professional Land Surveyors jonothanOlongsurvey.com ���` � OF A(qi ryonOlangsurvey.com ��P., , "Ib 1 hereby certify that I have surveyed the following described property: LOT 12, BLOCK 2, SPRING FOREST SUBDIVISION (PLAT No. 83-7) Anchorage Recording District, Alaska, and that the improvements situated thereon are within the property lines and do not encroach onto the property adjacent thereto, that no Improvements on the property lying adjacent thereto encroach on the surveyed premises and that there are no roadways, transmission lines or other visible easements on said property except as Indicated hereon. 4;t Dated this the Day of ""``` t at Anchorage, Alaska It is the responsibility of the owner to determine the existence of any easements, covenants, or restrictions which do not appear on the recorded subdivision plat. 48TH 1 KENNETH G. LANG No 542 ' ��li:�oFFss10R' State of Alaska AECC963 Tom Fink, Mayor / u icipality of Anchorage Department of Health and Human Services 825 "1.." Street P.O. Box 196650 Anchorage, Alaska 99519-6650 April 27, 1990- Roger & Joan Hickel 6121 West Tree Drive Anchorage, Alaska 99516 Subject: Lot 12 Block 2 Spring Forest Subdivision, Sewer Permit Number SW890106, PID #015-342-21 Dear Mr. & Mrs. Hickel: Please be advised that based on our inspection of your recently repaired and upgraded on-site wastewater disposal system, this office cannot issue final approval of the upgraded system. The upgraded system was not constructed in accordance with the construction permit that was issued by this office. That permit was issued based on our review and approval of a specific design that was prepared by your engineer, Leroy Reid, P.E. Prior to this office issuing final approval of the as-built submittal, the following items must be addressed: 2 o It is our understanding that construction of a new system was required because the old system had failed and/or had been inundated by shallow groundwater. If it is intended to alternate wastewater discharge between the old absorption system and the new absorption system, it must be confirmed that the bottom elevation of the old system is a minimum of four (4) feet above seasonally high groundwater levels. If groundwater monitoring confirms that the old system does have sufficient vertical separation from groundwater, this office has no objection to alternating wastewater discharge between the old and new systems. However, in order to effectively alternate flows between the two systems, a diversion valve must be installed. As currently configured, diversion of flows between the two systems would require complete replumbing of discharge piping beneath the house. Installation of the diversion valve was specified by your engineer in the original design submittal that was approved by this office. Roger Hickel Page 2 If ground water monitoring indicates insufficient vertical separation between the bottom of the old system and seasonally high groundwater, or if you decide not to install the diversion valve as specified in the original design, the old septic tank must be abandoned in accordance with the Uniform Plumbing Code and your engineer's recommendations. The as-built submittal has been returned to your engineer for resolution of the above items. If you have questions, /~lease contact our..office at 343-4744. J~hn Smith~ P.E.~ ~rogram Manager On-Site Services cc: Leroy Reid, Ph.D., P.E., Alaska Environmental Control Services Dan Roth, Civil Engineer, On-Site Services MUNICIPALITY OF ANCHORAGE MEMORANDUM DATE: TO.' FROM: SUBJECT: March 13, 1990 John Smith, P.E., Manager, On-Site Services Program Daniel J. Rot]], Civil Engineer, On-Site Servic~ Lot 12 Block 2 Spring Forest Subdivision, Sewer Permit Number SW890106, PID # 015-342-21, Septic System Abandonment After a site visit to Mr. Hickel's Lot, I have the following recommendations regarding the abandonment of the old septic system after the construction of the upgrade septic system: By Mr. Hickel's own admission on the day of my site visit, the old septic system is inundated with ground water for a period during breakup to a point where septic tank effluent cannot be accepted into the absorption field. As a result this office must require the monitoring of ground water to determine where the seasonal high water table is. ]if monitoring results are satisfactory then the old septic system could be given approval with some work done on the diversion system. Presently, if a person were to divert from the new system to the old system, it would require them to crawl beneath the house addition, into a hole, and physically cap off the new system and hook up the old system to the service line from the house. This method appears to be cumbersome. A diversion valve that can either be operated from ground surface beneath house addition, or better, electronically controlled in a utility room within the house is the proper means to change from the new system to an old system or visa versa. If monitoring results are unsatisfactory then the old septic system should be abandoned by filling in the tank beneath the addition of the house and permanently disconnecting it from the house service line. January 26, 1990 ROGER HICKEL 6121 WEST TREE DRIVE ANCHORAGE, ALASKA 99517 I~UNIClPAtI~ OF DEPT. OF HEALTH & RECEIVED Municipality of Anchorage Dept. of Health & Human Services P. O. Box 196650 Anchorsge, Alaska 99519-6650 Attention: Mr. John Smith, P. E. Program Manager Onsite Services Re: Lot 12, Block 2, Spring Forest Subdivision Permit #890106 Gentlemen: I recently received your letter regarding the onsite wastewater system at Lot 12, Block 2, Spring Forest Subdivision. I was surprised when I received this correspondence because I thought that our new onsite wastewater system was accepted and the permit closed out. Please review the attached documents and give me a call. Si~-. rely yo rs, .-~ R~g~/r Hickel RH:jm Er~closures Tom Fink~ Department of Health and I-~uman Services 825 "L" Street P.O. Box 196650 Anchorage, Alaska 99519-6650 January 8, 1990 Roger & Joan Hickel 6121 West Tree Drive Anchorage, Alaska 99516 Subject: Lot 12 Block 2 Spring Forest Subdivision Permit #890106, PID #015-342-21 The subject permit, issued by this office for a single family well and/or on-site wastewater system has expired as of December 31, 1989. Permits are issued on a calendar year basis by authority of the Municipal Code of Regulations. A new permit must be obtained from this office for an well and/or on-site wastewater system not installed by the expiration date. If you have drilled the well, a well log needs to be sent to this office for documentation of the installation and to close the permit. If a private engineer inspected the installation of the on-site wastewater system, the original as-built inspection report (three-part form) must be sent to this office for review, approval and documentation. When applying for a new permit, the fees are: $90.00 for an on-site wastewater permit; $50.00 for a well permit; $140.00 for a combined on-site wastewater and well permit. If you have any questions, please call this office at 343-4744. Sin~e~y, / / PrQ~ram Manager On-site Services JW/ljm:200 enc: Copy of Permit "Kids Are Our Future" CONSTRUCTION & ENGINEERING COMPANY P.O. Box 91515. Anchorage. A~aska 99509-1515 · Telephone (907) 349-1531 · Fax (907) 349-4686 FACSIMILE TRANSMITTAL Attn ~' ~ ~ ~ No Date: ~/~/~ ~, T~e: ~5~ Sheet 1 of / (incl. cover) Message: ! / r 375 East 76th Court. Anchorage Alaska 99518 · (907) 349-1531., Fax (907) 349-4686 One LakeBeilevueBuildin9' Suite101, Bellevue. Washington 98005 · (206) 455-4311 · Fax (206) 455-4386 CONSTRUCTION & ENGINEERING COIVIPANY P.O. Boxg'1515, Anchorage, Alaska 99509-1515 · Telephone (907) 349-1531 · Fax (907) 349-4586 FACSIMILE TRANSMITTAL ~,/' :.'~'_~ -~3 Reply: Yes Lr No .. Date: /0/7 /~ Time: {~!~77 ~ Sheet 1 of_~-/~ (incl. cover) Message: /. ,i , ~' . , {,j F ~,;~./ .,-{ Job Code 375 East 76th Court. Anchorage A~aska 99518 · (907) 349-1531 · Fax (907) 349-4686 One Lake Bellevue 8uiidit~,Suile ]01. 8ellevue, Washisglon 98005 · (206) 455-4311 · Fax (206) 455-4386 ALASKA uF1UIROIqlllel TAL COI1TROL SBi4UICES, linC. o ~n~inecrinq 6 (~nuironmenlel $1udies P. O. Box 240688 Anchorage, AK 99524-0668 (907) 279-5553 or FAX 276-8706 September 18, 1989 Mr. Roger Hickel 6121 West Tree Drive Anchorage, AK 99516 RE: Lot 12, Block 2, Spring Forest Subdivision Dear Roger: ~g-~7~ Recently, Dan Roth of the MOA, .Department of Health and Human Services, called me to say that they would not allow you to keep the empty septic tank under your house. The Uniform Plumbing code requires it to be properly abandoned. To no avail, I explained that you wanted to keep it for reserve. However, it will probably rust out quickly if it is not continuously used. It could then cause settlement of your footer where it crosses the tank. In your case, filling the tank with sand will work. You add dry sand in the standpipe at the edge of the foundation until it fills, then add water to level it out; then add more sand; then more water. Drain the excess water through the outlet. Continue the cycle until the tank is full. If you have any questions, please let me know. Sincerely yours, · Reid, Jr. PhD, PE, DEE President LCR/sr MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERWCES On-SIN Services Transmlt~l Sheet TO: LEGAL: ~ /2 ~ ~ j~/~//~ /C~y~ The attached paperwork has been reviewed and is being returned for the following reason(s): Discrepancy in legal description. __Discrepancy in number of bedrooms. Calculation error. Incomplete; needs Signature missing on Additional info needed Sewers/wells, curtain drains and streams within 200 feet not shown. Area soil/well information needed. Water sample unacceptable because Please supply the necessary information and re-submit your request. Your cooperation is appreciated. ReviewerS/'r /aen203-rev8/89 'i MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES Environmental Health Division 825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Name AddreSs Phone(st LEGAL DESCRIPTION BlOCk SubdiwSlOd Township. Range, Section No. of Bedrooms~ F~t~7L TANKS SEPTIC [] HOLDING DISTANCES WELL LOT LINE FOUNDATION SEPTIC / ABSORPTION WELL DIAGRAM (Show location gl well, septic system, property lines, Ioundation. water bodies, etc.) :%/ Capacity in ::~) No.o Compart:ns TYPE OF SYSTF. M TRENCH [] BED [] W. DRAIN [] OTHER original grade FT Fill added above original grade /~ FT Tots1 absorpllOn area //,/~.,'/0 $0 FT Number ot lines Soil raling ,ns,aller ~.~ ~C) ~ ~_~_~_~_~_~_~_~_~_~ Total depth from original grade Gravel depth benealh p~pe travel w~dth )islance between lines WELLS FT [] PRIVATE [] OTHER (Identifvl Classification (A,B,C) Depth Installer Dale Installed: ET REMARKS: I "~ ' /~4 ~ cerlily thst this inspection was pedormed according to all Municipal and State guidelines in effect on this dale: /~./"~,/ /~"~ ' T fENGINEER'S SEAL'~ · -. ~. ~ :.,' 72-013 (3/85) :!: N~L:;'J t'!l.,I,. 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ALASKA ENVIRONNIENTAL CONTROL SERVICES, INC. ].200 West 33rd Avenue, Suite B ANCHORAGE, ALASKA 99503 (907) 561-5040 JOB SHEET NO. / CALCULATED BY CHECKED BY SCALE OF DATE ALASKA ENVIRO[~[,~FNTAL CONTROL SERVICES, INC. " 1200 West 33rdl'A~enue, Suite /" ANCHORAGE, ~LA~SKA~ 99503 /' (907) 511-5~4 ~ ~g"~.~..~ SHEET NO CALCULATED BY '~' CHECKED BY SCALE OF V DATE E,/?./~' ~' DATE i , ' I CE - 2..251 ALASKA ENVIRONMENTAL CONTROL SERVICES, INC. 1200 West 33rd'-A~enue, Suite ANCHORAGE, ,~,LASK~ 99503 (907) 5, il-50~4 SHEET NO. ~ CALCULATED BY CHECKED BY /,,' SCALE ~ ~/C) / DATE DATE Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG m PERCOLATION TEST 1 2-- 3 4 5 6 7 8 9 10 11 12 13 14-- 15- 16- 17 18-- 19 / 20 COMMENTS Township, Range, Section: SLOPE -,t WAS GROUND WATER /~O'-/ ENCOUNTERED? S IF YES, AT WHAT ~) DEPTH? p E Depth lo Waler After Monitoring? ~/),- ~ Dat~ SITE PLAN Reading Date Gross Net Depth to ~-~c Net Time Time Watar~ .~ ) Drop PERCOLATION RATE '4~, X~(m,nutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN /~/ FT AND ~ ET ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES iN EFFECT ON THIS DATE. DATE: 72-008 (R er. 4/85) ALASKA tZlqUIROFIm IqTAL COFITROL. Sel,IUlCl $, II1C. ~nqint~ri~q [ ~nuir0nm~nlol $ludi~$ SPECIFICATIONS FOR A TRENCH-TYPE WASTEWATER DISPOSAL SYSTEM LEGAL DESCRIPTION: LOT i2, BLOCK 2~ SPRING FOREST SLJBDIVISION 1.O GENERAL 1.1 The Drawings, sheets I thru 4, shall be a part of this specification. 1.2 All materials and workmanship shall meet the requirements of the Municipality of Anchorage~ Department of Health & Human Services (DHHS), the conditions of the permit, and all applicable rules and regulations currently in effect. 1.5 All elevations and depths are advisory, and are to be verified or modified in the field by the engineer or inspecting agency. 1.4 It is the responsibility of the property owner or installer t(~..~adhere to approved designs for installation~ .maintain the specified separation distances~ an~ have the appropriate inspections. 1.5 It is the responsibility of the property owner or installer to report to the engineer any observed conditions which would put the sytem in violation of state or Municipal regulations. 1.6 I9 the installation is not inspected by an AECS engineer, AECS will not be responsible for the installed system. An engineer at AECS should be consulted prior to construction to determine the number' of inspections that will be required and to e×plain what these inspections will involve. 2.0 SEPTIC TANK 2.1 If there is an existing septic tank, it may be used it if meets the capacity requirement for the residence and the approval of the MOA. 2.2 The septic tank shall be a UPS-approved two-compartment tank, constructed of 12 gauge steel with bitumastic coating and set level on undisturbed soil. If the tank is buried at a depth of 4 feet or less, it must be insulated with an overlying layer of 2 inch burial type polystyrene rigid board insulation. 2.5 The septic tank and trench shall be a minimum of 100 ~eet from any private well or body of water~ 150 feet from Class "C" wells, and 200 feet from Class "A" or "B" wells, unless otherwise 1412 k,~V6gC 33~b c~v6nu6 · &ncho~zq6, &lzskz 99503 · 1907j 279-55']3 2.4 2.5 2.6 2.7 specified. Less than the required separation distance must have prior approval or waiver by ADEC or MOA. The septic tank shall be a minimum of 5 feet from the house foundation, and a minimum of 5 feet from the absorption area. Piping shall be fitted with a mechanical watertight calder coupling on the outlet and inlet of the septic tank. Piping shall be 4 inch solid PVC ASTM D-3034 or cast iron, sloped a minimum of 1/4 inch per lineal foot. If the piping is buried at a depth of 4 feet or less, it must be insulated with an overlying layer of 2 inch burial type polystyrene rigid board insulation. Cleanouts shall be installed as designated and capped with air-tight rain caps (Jim Caps or equivalent), and extended a minimum of 1 foot above ground level. If a lift station is required it shall be a combination lift station septic tank per Anchorage Tank and Welding, Inc. design. Specifications and design drawings are on file with the Municipality and the engineer. 3.0 ABSORPTION AREA The gravel for the trench shall be 0.5 to 2.5 inch, screened rock with less than 3 percent passing the No. 200 sieve. All substitutes must have prior DHHS approval. 3.2 The bottom and sides of the excavation shall be raked with the backhoe blade to ensure that it has not been compacted during excavation. The bottom elevation shall be level. Monitor standpipe(s) shall be placed as shown in the drawings, and shall be 4 inch rigid PVC ASTM D-3034, or cast iron. The section shown with holes may be 0.5 inch holes drilled on 6 inch centers on opposing sides of the pipe, or a regular section of perforated sewer pipe clamped to a solid section with either a no hub coupling or a solvent joint. A rubber rain cap (Jim Cap or equivalent) shall be installed over the top of the pipe. '~.4 The distribution pipe shall be perforated 4 inch PVC with a minimum crush strength of 1500 pounds MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT MAI ~.LN~ ADJ}R ESS LOCATION I DISTANCE TO: I I in gallons[ IF HOMEMADE: IW~ DISTANCE ~fi~ Absorption area~ t~ - Dwelling/¢~ Materia~--~ Width Inside length welling Material NO, OF BI~DROOMS I PERM%O, Liquid depth DISTANCE TO: lines Top of tile to finish grade Length Type of crib each line Foundatior Material beneath tile Depth Liquid capacity in }don area PERMIT NO. Crib diameter Well DISTANCE TO: Class Depth DISTANCE TO: Building foundation OTHER PIPE MATERIALS ! REMCRKS Crib depth Total effective absorption area Building foundation Nearest lot line Driller Distance to lot line Sewer line Septic tank PERMIT NO. Absorpt on area(s) APPROV ~_~¢. ¢~'~~ ?~TE 72-013 (R~b~, 3/78) kEGAL ~ O ,~..0-~v''''~ 8;;~.5 "' L '" '_T,'I'RIEE:T., FINE:HOI:::iFIEitE., Fli.;::. 0 N ....... ~; ~ T F ,=: E= p ~ E~:- ~, P ~ ~" M '[ -F 5 "~~. F'EI~:I"'I:I.T NF). ,' ~:',':i~:::2~R ':, . .......... RF'F'LtCRN"I" RO:~E:R I"IIF::KEL 5RF:~ BO',:.:: SE~N ctq~E/1 ~~5":~-,~ L 0 C Ft'T ]~ '] N I,,..EGR[. L. OT' :1.2 E',LK 2 2;F'~ING F'OREE;]" SFJE', T'¢F'E (IF SOIL. IZlE::5ORF:"TION :5'r:5;TEM IE;: TI~:ENC:FI i"IRX:t:I'ILIM NLIMBER OF' E~EI}ROOMZ = 4 .... I] ......... I - ~ ~ ....... , ':' , THE REQUIRE[:, SZZE OF' THE SOIL HE,:,_F.F~.[..I.~ THE I....ENG]'H DII'"tEI',tL:;IOI',I I:E'; 'TFIE LENGTH '.'.'IN FEE:T.':, OF:' THE: 'FREI"4CH OR [:,RF::IINF::'IEL[:,. TFIE [.':,EF'TI.*I OF Fl TF,;:ENCFI OF;i: PIT IS THE; [:,ISTRNE:E E',ETI-,.!EEN ]';'.lEi: %URF'FICE: OF TFIE GROUN[:, FINE:, THE E',OT]"OM OF THE E',:-::CRVRTION ,:.'I1"4 FEET). 'I"HEREE IE; NO SET I.,.1I[:,]"I-I FOR TREI",IE:F-IEE;. TI-.E.:.: GF.".FIVEI_ [:,EF'TFI ]:~.; TFIE I"'III'-,IIh'tUM C, EP]'FI OF: GRFIVEL BETP.IEEN TFIE OUTF'I.:IL.L. Pt I::'E' FINE:, TFIE E:OT'TOM OF 'I'HE E;:.:;C'Ft',,,'F:I"r'Ioi'.,I ,:: I f.,t FEET). I::'ERM I T F:II.:'PL I CFiNT' F-.IF:IE; 'THE 1:4:ESF'F$1S i B 'r L I 'T¥ TO I I'.,tFOF~:M T'H I E; [:,EF'FIR'THENT' [:4..IR I NG I-FIE :FN~STF:ILL.F::ITtON INE;PECT'[ON'.::.'; OF' i::11'.,1'~.' /41ELLS F:IDJFIF::Ei',I-I' TO 'I'H.[.::, PRCdU:'EF.:T'.r' F:II',tE:, THE NUMBEF:.': OF RES ZI}Fi!]'-,k]ES TI.'FF:tT TI-IE I.,~EI_L !-,.IZLF.. '::'F:'C",,'~:' E:FIE:I':.':I:: I L.L. I i",lEi E F:: FIl',t'¢ L:;"r';~;TIEM 1.41 '/"FIOIjT I= I NFIL 'r t'.I':SF'Er.::T I ]1'.,t FIl'.4[:, FIF'F'I.~:O',,,'RL E'h' TH ): S [.EF-F. II1EI',t"I t.,.tILL. E:E :,IJE,._E.._.T ]"O F'I~?F":E- TION. MI I',tIHUH [:,IS'T'FII'-,ICE E:ETI.,.IEEN Ft ,NELL. RN[:, FIN'.? ON-STTE SENRGE D ISF:'OSFIL S?¢S'TEH IS :L.E'~EI F:'EiET I:'OR F:t PRIVFITE NELL, OR ±SE~ TO 2~EI FEET FROM fl PFJE~I..IC .WELL DEF'ENDING I.JF:'f.'.)N THE 'F'"~"I.:'E OF PI JEIL. t C l.,.hEF..I. .... MII",IIMLIM C, I2;TF:INCE FF.:OM I::'1 PRI',,,'FITE I.,.IELL TO FI PRIVFtTE: :E;IEI4EF.': L. INE I:E; 25 FEET I:11',t[:, TO F:l COI"~HUNIT'¢ SE],.IER LINE I.'-:; 75 F:'EET. OTHEF.: I.;;:E:QFJZREMENT$ MFI"¢ RPPL'¢. SPEC IF ICFIT IONS FIN[:, CONE;'f'RUCT ION [:'I FIGRFtME; I::IRE F:l',,,'l:~ l LFIBLE TO I NE;UF.:E F'F.':OF'EF~: t I',I:E;T'FIL.L. FIT I ON. I CERT' I F"r' "1" "iFt'i" :1.: I Fl" F.'i.:lH]l....II::tF.: I.,.!ITFI 'THE: REQUII:~tE]"'IENT!~; FuF: ON-SI]"E SEI.,-IERS FIN[:, 1.4EI_L:E; FIS SET FORTH B'¢ THE MUI'.,I I C I F'FIL. Z T'-,.' 01::' FINCFIOF.'.FIGE. 2,: I I.,~ilL..L INiSTFII_I_ THE S"r%TEM IN F:ICCORE:,FINE:E !.,.IITH THE CODES;. 3: I LIN[:,EI~'.:E;TFtND TFIFIT TFIE ON-SITE 5EI.,.IEF.' L:;"r':E;TI..EM t"'lFt"¢ REQLIIRE EI",ILF:IRGEI"IEI"4T :FI'::' THE R E S I ~:' E N C E :i: 9 R E I'"10 E:' E L .E: [:, T 0 I I",1C L IJ E:' E M O R E 1'I-"1FIl",l 4 E: E D F.: 0 O I"1S. (', -MU.lCIP^LITV OF .C"'OR 'nE ' DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION IJ~S L St,'eel, AKhMeO,e, 'AIoIkI 90501 2644720 SOILS LOG - PERCOLATION TEST lEGAL DE$CRIPt;ON: :3 4 8 9 '12 17 LOG PERCOLATION SITE PLAN WA~ GROUND WATER ENCOUNTERED? ~,~(~ E IF YES. AT WHAT .._._.- DEPTH? * Gross Ne! Depth to NeT Reading Da~e Time Time Water ............. ~ ~ ~8 370 R. Nichols , ~ '~. , ~ 0 .. PERCOLATION RATE ~) '__(mlnutH/i~ch) · ~'. ,~ ~J'JJJ~ ~-_*',aA % ~' 'EST RUN OETWEEN ........~..~.. FT AND ~u~.T~ ~T"::'YYT'.'/.'.' .....~ ~ ~ - FT MUNICIPALITY OF ANCHORAGE DIVISION OF ENVIRONMENTAL HEALTH DEPARTMENT OF HFA[YfH AND ENVIRONMENTAL PROTECTION APPLICATION [~DR HEAl]TH AUTHORITY APPROVAL CERffIFICATE General Information Application Date (a) f~.gal Description (in61ude lot, block, s~ubdivision, section, t~nship, range) Loc~tion (add~ess o~ directions) (b) ADp 1 icants Nar~__~..~=__ ~/~--ik__~ri Te lepJLqne Applicants Add~ress~_~/o~ } (c) __ ~¢~ .__' Lending ; ADDi~ ~ant is (check one) Institution C~ O~ner/builder ; Buyer ~__[~ Othel, -~-----I (s~lain); (d) Lending Institution Telephone Address ~ (e) Rmal Estate Co. & Agent Address Te le phor. e 2, Jfl ., of esidenee Single-Family Numbe~ of ~edroor~ 3o te= 9 l Individual ~%11 Multi-Family ~_--~ O~er (~s~i~) C~,,nity .,_~_;,.J/ Public Note: If c~m~]nity ~].]. system, must have w~itten confirmation ~cm t~he State Depa~tn~nt of 5~avironm~ntal Conservation attesting to the legality and status. Is the ~.,11 adequate fo~ the n,~er of bedrccms specified in this HAA ~b) 4. ~9 Dis~c~sa__l_ Onsite I~ Public I_~_~~ (br~.unity [--~ Holding TapJ< C~ Is the wastewater disposal s~stem adequate [er. the n,m~ber of ~drocms ~/N) [Page 1 of 2] 2-15-84 5..E~n~qirmerincI Firm Providin¢~Ins~.Dections, 'Ibsts, D~ta and Information I certify that I have checked, verified, or conformed to all Y~A HAA Guidslires in effect on the date of this inspection. S igr~d by Telephone (ENGINEER SEAL) 6. DHEP Approval Approved f a~___~/ lmdr ocms .Approved E.~-] Disap[~oved F--'[[ Ternm of Conditional ApprovB1 ~) ~j--,;~.;-~-~ 2he Municipality of A~cho~age Departr~nt of B~a!th and Envirorm%ental P~otection dces not guarantee the continued satisfactory [~.rfomnance of the wate~ supply and/or the wastewatez, disposal system. This approval indicates that, as of th~ validation date shown six,ye, based on the data and information furnished by an engineer registezmd in the State of Alaska, the w~ter supply and wastewster disposal system is safe and func- tional for the ntuRber of ~drcoms and type of stl~ucttl~e indicated. ( [~EP SEAL) 7. Mail the HAA to the fo].lc~ving address: [Page 2 of 2] 2-15~84 ae MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 NVIRON :NTAL PROD:c1]oN Total DeptJ% A~_2__ Cased to ~'LP/~c- Depth of G~outing. Pump S~t At Static Water Level ~/;~ Casing Height Above Ground Electrical Wiring in Conduit (Y/N) Separation Distances i~c~ Well: To Septic/~olding Tank on Lot Sanitary Seal on Casing (.Y/N__J)~J./~ _ Depression A~ound Wellhead (Y/N)~3/'~ On' AdjoiniJg Lots ; On Adjoining Lots To Nearest Public Sewer To Nearest Edge of Ab~'o~ption Field on Lot To Nearest Public Sewe~ Line ~[/g Cleanc~t/Manhole ~%~//~ To Nearest Sewer Service Line on Lot Water Sample Collected By I/~)/z~- ; Date /%~/7~ Water Sample Test l~sults ~J/~ B. SEPTIC/HOLDING TANK DATA Standpipes/~N) Air-tight Caps ~/N> Foundation Cleanout ~_~N) - Depression over Tank .(Y Date Last Pumped ~ Pumping/Maintenano~ Contract on File ~ ; for Holding Tank High--Water Alarm (Y_~ ~t~/~__ Temporary Holding Tank Permit (Y/~ Separation Distances f~om Septic/Holding Tank: To Water-SUpply Well ~7//% To Property Line /~0 To Water Main/Service Line co se To Building Foundation To Disposal Field fO ' To St~eam~ Pond, Lake~ o~ Major D~ainage [Page 1 of 2] 2=.15~84 C. ABSORPTION FIELD DATA Do Soils Rating in Absorption Strata Date Installed ~/~j Width of Field ~ ~ ,sg~!/f~ Type of System Design Length of Field /~b-/ Depth of Field /~9/F Gravel Bed Thickness ~,~ ! Square Feet of Absorption a~ea ./7~--~-~' ~ Standpipes P~esent ~9/N) ~p=ession ove~ Field (Y~ ~te of ~st A~a~ ~st Results of ~st ~e~a~ ~st Separation Distan~ ~ ~s~ption Field: To ~te~-Supply ~11 ~ To ~o~rty Li~ To Building Foundation /o~ To Existing Lot ~/~ ; ~ ~joining ~ts To Water Main/~=vi~ Line ~/O ~ To ~t~(if pre~nt) To St~e~ond~ke/~ ~jo= ~aina~ C~se ~/~ To ~iveway, Pa=ki~ ~ea, ~ Vehicle Stora~ ~ea ,~ ST T ON Date Installed /~///~ Size in Gallons AJ(~ "Pump C~" Level at ~]/~ Aj//C High Water ~ ~vel at Tested fo~ ~/~ Electrical Codes(Y/N) C~nts Dimensions /%3/~ Manhole/Access (Y/N) n){/~ "Pum~ Off" Level at ~3(/~ Vent (Y/N) ~/~ .~ing Cycles ~ing Adequa~ ~st. Meets MOA ** Check Permitted Bedroc~ Rating A~ainst HAA Request I certify that I have checked, verified, or conformed to all MOA HAA Guidelines in effect on the date of this inspection. Signed KB1/d5/s [Pa~e 2 of 2] ALASKA ENVIRONMENTAL CONTROL SERVICE~= INC. 1200 West 33rd Avenu., .;uite B ANCHORAGE, ALASKA ~9503 Phone 276-1361 JOB S,EET .o / or / CALCULATED BY DATE